复发性胃癌手术消化道重建难点及方式合理选择

梁 寒

中国实用外科杂志 ›› 2015, Vol. 35 ›› Issue (10) : 1053-1055.

PDF(376 KB)
PDF(376 KB)
中国实用外科杂志 ›› 2015, Vol. 35 ›› Issue (10) : 1053-1055. DOI: 10.7504/CJPS.ISSN1005-2208.2015.10.06
专题笔谈

复发性胃癌手术消化道重建难点及方式合理选择

  • 梁    寒
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摘要

复发性胃癌采取手术治疗可以显著提高病人的存活率。残胃复发癌的根治性切除率可以达到50%。复发性胃癌或残胃癌手术多采取全残胃切除术,全残胃切除术后最常用的消化道重建是Roux-en-Y(RY)术式。RY+空肠贮袋也是备选方法之一,小贮袋(7~15 cm)具有更明显的临床优势。间置空肠作为全残胃切除消化道重建的推荐术式仅适用于Billroth I式重建后,且残胃复发于非吻合口残胃并获得R0切除的病例。应该根据病人的具体情况合理选择重建术式。

Abstract

Rational surgical reconstruction of digestive tract for recurrent gastric cancer        LIANG Han. Department of Gastrointestinal Oncological Surgery, Tianjin Cancer Hospital, Tianjin Medical University; National Clinical Research Center for Cancer; Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin 300060, China
Abstract    Reoperation can improve survival for patients with recurrent gastric cancer. A total of 50% of all recurrent gastric cancer can be radical resected. Total gastrectomy is usually performed in recurrent gastric cancer and gastric stump cancer cases and Roux-en-Y (RY) reconstruction is the most common procedure. RY plus jejunal pouch is one of spare options for reconstruction. More clinical benefit can be obtained by small pouch (7-15cm). Indication for jejunal interposition is no recurrent gastric stump cancer located in anastomosis which can be R0 resected after Billroth I reconstruction. The rational reconstruction will be made according to the individual patient’s condition. 

关键词

胃癌 / 复发 / 消化道重建

Key words

gastric cancer / recurrence / reconstruction of digestive tract

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梁 寒. 复发性胃癌手术消化道重建难点及方式合理选择[J]. 中国实用外科杂志. 2015, 35(10): 1053-1055 https://doi.org/10.7504/CJPS.ISSN1005-2208.2015.10.06

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